Resuscitation of the elderly

Concerns about quality of life and the cost of medical care raise questions about the effectiveness of cardiopulmonary resuscitation (CPR) efforts. This study explores the role of age in resuscitation outcome by focusing on the CPR experience of all patients age 75 years and older in a community hospital during a one-year period. Data are based on a retrospective study of the medical records of 86 such patients. While 41 percent survived the initial resuscitation effort, only 23 percent regained conscious functioning, 12 percent left the hospital, and only 7 percent survived to be discharged from the hospital and were alive one year later. None of the 26 patients over the age of 85 survived resuscitation. Among the 75 to 84-year-old patients, the diagnosis of acute onset arrhythmia and dementia were associated with a better survival prognosis. Crude estimates of cost based on charges for crash carts, intensive care, and bed rates totalled over $100,000; over one-half the amount was allocated to the 21 patients who were unconscious before finally dying the hospital. The study suggests the importance of continuing discussion about quality of life and cost implications of resuscitation of elderly patients.